Quadricuspid aortic valve: an unusual echocardiographic finding and a review of the literature.

This case report presents a rare clinical finding of an isolated quadricuspid aortic valve in an otherwise healthy 24-year-old female who was referred for cardiac evaluation due to newly identified murmur. A transthoracic echocardiogram suggested an unusual case of a bicuspid aortic valve with two raphes with normal opening and mild aortic regurgitation. This case exemplified that caution should be taken when encountering circumstances like the one presented, as the aortic valve anatomy might be mistaken based on a new proposed classification for bicuspid aortic valves recently published. Further evaluation identified the presence of a quadricuspid aortic valve using computer tomography of the chest. Care should be taken in evaluating aortic valves as in this case. The literature regarding quadricuspid aortic valves is reviewed.